Assessment Instruments

The Trauma Center has developed a packet of self-administered questionnaires for adults that assess psychological traumas and their sequelae, including features associated with “disorders of extreme stress” or “complex PTSD”. The test instruments included in this packet provide a comprehensive assessment of trauma histories at different ages and the broad spectrum of posttraumatic adaptations encountered in clinical work. Clinicians can chart patients’ progress over time by collecting information at the initial intake visit and three follow-up visits.

Trauma Assessment Packet

IMPORTANT: Here is a software update to correct the total score for PTSD. Please download the Instructions and INSTALL link.

A. Traumatic Antecedents Questionnaire (TAQ):

Description:

The TAQ is a 41- item self-administered instrument which gathers information about lifetime experiences in ten domains: (1) competence, (2) safety, (3) neglect, (4) separations, (5) family secrets, (6) physical trauma, (7) sexual trauma, (8) witnessing trauma, (9) other traumas (i.e., natural disaster, serious accident), and (10) exposure to familial or personal alcohol or illicit drug use. The first two domains represent experiences of adaptive functioning, while the latter eight domains assess exposure to traumatic or adverse experiences. These domains are assessed at four different age periods: early childhood (birth to 6), latency (7 to 12), adolescence (13 to 18) and adulthood. This instrument allows calculation of summary scores for each of the ten individual domains, as well as across the four developmental periods. While designed as a self-report measure, the TAQ can be administered by the practicing clinician to guide or enhance evaluation of exposure to formative life experiences, with emphasis on exposure to overt and subtle forms of exposure to interpersonal victimization, exploitation and disrupted caregiving as well as to exposure to important protective experiences within pivotal caregiving relationships or as a function of personal resiliency. As such, the TAQ provides invaluable information for guiding clinical inquiry and developmental formulations.

Scoring:

For each item of the TAQ, respondents are asked to rate the extent to which they had a particular experience during each developmental period on a scale from 0 to 3. Numerical markers represent both frequency and severity of experience. Summary scoring for the TAQ is complex, and the accompanying detailed scoring instructions and template should be used to facilitate translation of raw item scores into summary scores by domain and by developmental period. In general, higher scores on the two adaptive domains represent greater levels of adaptive functioning, while higher scores on the eight trauma/adverse event domains represent greater levels of accumulated risk. Extensive clinical use of this measure at our Trauma Center’s complex trauma specialty outpatient clinic suggests that particular indicators of concern are (a) low scores on early childhood measures of competence and/or safety; and (b) presence of multiple forms of trauma exposure occurring during two critical developmental sensitivity periods: early childhood and adolescence. In addition, cumulative exposure to combined exposure to physical, sexual and emotional abuse across the lifespan was found to be associated with greatest likelihood of expression of complex clinical adaptation in the form of complex posttraumatic stress (C-PTSD). In contrast, exposure to impersonal trauma (e.g., accidents, disasters) in adulthood was found in our clinical sample to be most predictive of classic PTSD.

These 45-item scales assess presence and/or severity of the Disorders of Extreme Stress Not Otherwise Specified (DESNOS) diagnostic construct, which reflects the Associated Features of PTSD commonly seen in association with interpersonal stressors: impaired affect modulation; self-destructive and impulsive behavior; dissociative symptoms; somatic complaints; feelings of ineffectiveness, shame, despair, or hopelessness; feelings permanently damaged; a loss of previously sustained beliefs; hostility; social withdrawal; feelings constantly threatened; impaired relationships with others (DSM-IV, p. 425). The clinician-rater version was used for the DSM-IV Field Trials for PTSD, and has been validated as a measure of DESNOS diagnosis. The self-report version has good behavioral anchors and has demonstrated good internal reliability as a measure of current DESNOS severity. Both version of the SIDES consist of six major scales with related subscales: (1) alteration in regulation of affect and impulses, (2) alterations in attention or consciousness; (3) alterations in self-perception; (4) alterations in relations with other; (5) somatization, (6) alterations in systems of meaning.

C. Trauma-Focused Initial Adult Clinical Evaluation:

This structured clinical interview was developed at the Trauma Center to facilitate a comprehensive intake for new patients. It focuses on trauma history and associated symptomatology with an emphasis on developmental, current internal resources, social supports, substance abuse and treatment history. It is informed by empirical findings based on the TAQ, SIDES and PTSD instruments. We invite you to utilize this instrument verbatim or adapt and modify it to best meet the needs of your client populations, service types, and settings.